VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1214008
Sex: M
Age: 51
State: AZ

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Light Headache followed by mild nausea.

Other Meds: Lisinopril, Chlorthalidone, Atorvastatin, omega 3 in Krill and Fish Oil, Turmeric, Garlic, Vitamin D3, low dose aspirin, CoQ10, Allertec (Cetirizine Hydrochloride), Vitamin C, Men's Silver One-a-day Multivitamin

Current Illness: none

ID: 1214009
Sex: M
Age: 69
State:

Vax Date: 03/03/2021
Onset Date: 03/22/2021
Rec V Date: 04/15/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: N17.9 - AKI (acute kidney injury) (CMS/HCC) N17.9 - Acute renal failure, unspecified acute renal failure type (CMS/HCC)" R79.9 - Elevated BUN R79.89 - Elevated serum creatinine

Other Meds:

Current Illness:

ID: 1214010
Sex: M
Age: 46
State: FL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No allergies

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Date and time adverse event started: 04/11 8-9p.m. (bad headache, flu like symptoms, nausea, chills, lethargy) Adverse events experienced and are they still occurring now: aches and pain subsided , still experiencing dizziness when getting up and working, lightheaded when standing for long periods of time Recommendation: please call your doctor for a check up, I would also recommend you to get tested for COVID just to make sure you don't potentially have it

Other Meds: -statin

Current Illness:

ID: 1214011
Sex: F
Age: 31
State: IN

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: fever - 101 degrees for 36 hours migraine malaise

Other Meds: na

Current Illness: na

ID: 1214012
Sex: F
Age: 67
State: FL

Vax Date: 01/14/2021
Onset Date: 03/04/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After 2d vaccine. Fever 101,fatigue, body aches, stomach cramping and pain, headache then diarrhea/ gas for 2 days Then 3 weeks later Fever 100.4. Stomach pains and diarrhea and gas for 24 hours. Then 2 1/2 weeks later Fever 100.3 stomach pains, diarrhea and gas for 24 hours

Other Meds: calicium glucosamine/chondroidin eye vitamins-areds 2

Current Illness: no

ID: 1214013
Sex: F
Age: 54
State: CO

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: nkda

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: patient reports a creepy crawly sensation that starts in right shoulder blade and wraps around to right breast. very bothersome. began about 1 week after vacccine

Other Meds: metformin, jardiance, nph, gabapentin

Current Illness:

ID: 1214014
Sex: M
Age: 33
State: WA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient was in post observation and reported to post observation RN dizziness. While Pt was speaking with RN, he had "full body convulsions/twitching and his eyes rolled back". The post observation RN reported this event happened 2 times and was done in less than 2 min. EMT's called to scene. Pt reported ringing in ears, and was diaphoretic after the event. Pt was immediately able to speak, and drank water. Pt was not postictal. Pt became pale after vaccine administration. No PMH, No Allergies, No meds taken daily or given at site. VSS throughout. EMTs took over care of Pt and stayed with Pt until wife came and picked him up. VS: BP: 118/78 HR: 68 RR:22 O2 sat: 99% on RA

Other Meds: unknown

Current Illness: unknown

ID: 1214015
Sex: M
Age: 38
State: WI

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Error: Diluent Administered Instead of Vaccine

Other Meds:

Current Illness:

ID: 1214016
Sex: F
Age: 26
State: CA

Vax Date: 03/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: MACROBID, PCN, SUCRALFATE

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt called in for nurse triage d/t increased heart rate 130-150, severe headache, chest pressure. Pt did not obtain vaccine via our clinic. Pt unable to provider lot #

Other Meds: ELLA, FAMOTIDIN, FLUTICASONE NASAL SPRAY, OMEPRAZOLE

Current Illness: PELVIC PAIN, TONSIL STONES, DYSURIA

ID: 1214017
Sex: F
Age: 60
State: OH

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient vaccinated and complained initially of tingling sensation in fingertips at 1025. Patient went to bathroom 10 minutes later. At 1045 patient began complaining of coughing, throat was "tight", face was visibly flushed. RN called Pharmacist requesting Benadryl. Patient declined the liquid Benadryl offered by the pharmacist. Patient had her own Benadryl 25 mg tablets in her car. She agreed to take one 25 mg Benadryl po at 1050. Patient normally takes 50 mg po every day and wanted to take another dose so she did at 1053. Pulse was 60 and regular. Patient did have relief of symptoms, decreased flushing, decreased throat tightness, and more calm after 30 minutes. Patient agreed to wait awhile longer. She was encouraged to follow up with her primary care doctor to discuss reactions and to determine how to proceed regarding getting a second dose of Pfizer vaccine. At 1215 patient felt fine to drive home. She was accompanied by her son. RN to call patient later to see how she is feeling.

Other Meds: Losartan 50 mg qd; benadryl 50 mg qd; OTC vitamins.

Current Illness: Hypertension

ID: 1214018
Sex: F
Age: 57
State: TX

Vax Date: 01/18/2021
Onset Date: 01/22/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Codeine

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: This follow up report: I still have these: Rattle in my throat - I notice this when I laugh; constant congestion - it's always there. It's like I can't clear my throat. I have a hard, dry, hacky cough. It has a deep sound to it. At that time when I made my first report I had shortness of breath but I think getting better as I have started exercising. No treatment but I do try to drink hot lemon water at night to help with congestion.

Other Meds: Vitamin C, Vitamin D3, immune Defense, Fish Oil

Current Illness: no

ID: 1214019
Sex: F
Age: 37
State: PA

Vax Date: 02/28/2021
Onset Date: 03/02/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Herpes zoster rash on face. Started week after first shot. Still healing today.

Other Meds: Hydrochloride

Current Illness: None

ID: 1214020
Sex: F
Age: 19
State: WI

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Extreme fatigue lasting over a week, inability to workout without abnormal extreme soreness, poor digestion and nausea for over a week, looking pale and gaunt to the degree of notice by others, overall feeling bad consistently over a week.

Other Meds:

Current Illness:

ID: 1214021
Sex: M
Age: 71
State: TX

Vax Date: 03/04/2021
Onset Date: 04/02/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: sulfa drugs

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: on 4/13/2021 patient had his 2nd dose of moderna vaccine and his symptoms included: fatigue, myalgias, daytime somnolence, and lack of mental clarity. he feels lots of pain, of burning in nature, to his b/l lower extremities. the above actually happened after his allergy shots which was given after his 1st covid-19 shot, but these symptoms became more accentuated after his 2nd MODERNA vaccine

Other Meds: ATORVASTATIN 40, SYMBICORT INH, FLUTICASONE PRO 50 MCG, "ALLERGY SHOTS", vit d, zinc, vit c

Current Illness: essential hypertension , allergies rhinitis/sinusitis

ID: 1214022
Sex: F
Age: 48
State: CA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: bees, animals, pollen, dust, multiple foods, erythromycin, medicine w/ membranes.

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: pt says that she had a low grade temp, body aches and pains. On 4/11/2021 she was walking across the room and her knee dislocated then when back into place. Her shoulders, ankles, wrist and joints in her spine go in and out. Her CSF leak has gotten much worse. She cannot turn her head without having a problem. Her tremors from EDS are getting worse. She has an enlarged uvula and lymph nodes. She had virtual appt w/ PCP on 4/14/2021. she was prescribed antibiotics and told this was a flare up and her symptoms should get better within 6 weeks but is also going to FU w/ her specialist on 4/22/2021.hlers-Danlos Syndrome, MCAS, CSF, Spinal Instability, POTS, Dysautonomia, Asthma

Other Meds: Percocet 10-325mg qd, Acadian 100mg bds, Soma 350mg qd, clonazepam .5mg bds, Singulair qhs, Claritin qd,

Current Illness:

ID: 1214023
Sex: F
Age: 56
State: AZ

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Fish , seafood, bee stings

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Hives suddenly appeared and spread quickly on left arm and on left ribs

Other Meds: B12, C, probiotics, Celicia, Flonase, Amberen

Current Illness: None

ID: 1214024
Sex: F
Age: 54
State: GA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: PEAS. OLIVES, ROSES, CHOCOLATE, COFFEE

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Upon receiving shot pain shot down arm to left hand. When standing up felt faint. Remained in store for 20min until fainting feeling subsided. That night got fever, chills, muscle aching, joint pain, abdominal pain and nausea, diarrhea severe headache. The fever and chills stopped next morning. Continued having moderate muscle aching, nausea and severe headache for 3 days. On the line of severe migraine. It has been 6 days and I still have mild muscle aching, joint pain, nausea, headache, fatigue, and faint.

Other Meds: XANAX 0.25MG (1 TABLET AT BEDTIME FOR SLEEPING)

Current Illness: NONE

ID: 1214025
Sex: M
Age: 53
State: CT

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Cephalexin, Percocet, Mushrooms

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Received the first shot of Pfizer Covid Vaccine at 10:00 AM on 3/21/21. Aside from some drowsiness I felt fine the entire day. Then that night I woke up at 2:30 AM with severe pain in my right knee. I was unable to bend the knee or walk for the next 36 hours. After that the pain transitioned to the back of my calf muscle for the next few days. The pain then went back to my knee for a day and then returned to the back of my calf muscle. On 3/30/21 I saw my primary care physician who then sent me to get an ultrasound which determined that the pain in my knee and calf were caused by blood clots (DVT). I was then prescribed Eliquis 5 mg blood thinners.

Other Meds: Multivitamin, Glucosamine Chondroitin

Current Illness: None

ID: 1214026
Sex: F
Age: 62
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Vaccine Administration given in wrong site. It was delivered Sub Q Am I vaccinated? Do I need another dose. Large Hot red Spot 4 inches above elbow. Missed Deltoid by 3-4 inches

Other Meds:

Current Illness: Phempigoid

ID: 1214027
Sex: M
Age: 77
State: PA

Vax Date: 03/23/2021
Onset Date: 04/05/2021
Rec V Date: 04/15/2021
Hospital: Y

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Dobutamine - anaphylaxis Gabapentin - reaction unknown PCN - unknown Aspirin = swelling lactose - diarrhea IV contrast - anaphylaxis

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Hematologist/oncologist diagnosed patient on 4/12/21 with hemophagocytic lympohistiocytosis (HLH) with CNS involvement. Patient met 6/8 HLH-2004 diagnostic criteria. 6/8 results were able to be evaluated; awaiting 2/8 evaluable. Probability per provider of having HLH is greater than 99% using the validated H Score. The trigger for the HLH appears to be deranged immune activation by the COVID-19 vaccine within the setting of prolonged immunosuppression for transplanted heart. Due to presenting with severe headache and elevated protein in CSF = Intrathecal chemotherapy was initiated. Treatment: HLH-94 Regimen Dexamethasone Etoposide Possible Rituximab - will only start if EBV DNA is positive

Other Meds: Medications on the prior to admission medication list; presumably could have been taking at time of vaccine administrations in February and March 2021. Acetaminophen 325 mg PO every 4 hours as needed Aspirin 81 mg po daily Calcium carbonat

Current Illness: 3/31/2021 brief hospitalization (discharged from obs unit on 4/1/2021) due to diarrhea and when presented back recurrent fevers, weakness, headaches. At the 3/31 obs stay reported a few month history of poor appetite, malaise, fatigue, poor appetite.

ID: 1214028
Sex: F
Age: 60
State: CO

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: red rash on my upper left arm around the injection site.....itchy

Other Meds:

Current Illness:

ID: 1214029
Sex: F
Age: 83
State: PA

Vax Date: 03/24/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: 16 days post first Pfizer corona virus vaccine, patient experienced hallucinations of see multiple people in the backyard who were not there. Hallucinations occurred again 2 hours after 2nd dose of Pfizer covid vaccine (injected 4/15/2021 lot EW0153, left deltoid).

Other Meds: vitamin b, vitamin d

Current Illness: UTI in January 2021

ID: 1214030
Sex: M
Age: 59
State: TN

Vax Date: 03/15/2021
Onset Date: 03/30/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nkda

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: thrombosis of superficial vein of lower limb

Other Meds: albuterol, aspirin, benazepril, diazepam, breo, nexium, flonase, naproxen, simvastatin, tadalafil

Current Illness: n/a

ID: 1214031
Sex: F
Age: 29
State: MI

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Injection site pain, Pain

Symptoms: Headache, redness/pain at injection site, vomit/nausea, muscle aches, loss of appetite, lethargy, hand tremor for a week post vaccination, tingling/weakness in right side continuing 2.5 weeks post vaccination

Other Meds: None

Current Illness: None

ID: 1214032
Sex: M
Age: 46
State: OH

Vax Date: 03/25/2021
Onset Date: 03/30/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient says he has been experiencing severe muscle pain for approximately the past 10 days. He received the first dose over 3 weeks ago. The pain is almost unbearable per the patient. I instructed patient to get immediately with his md.

Other Meds:

Current Illness:

ID: 1214033
Sex: F
Age: 38
State: TX

Vax Date: 04/03/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Rash on left arm around vaccination area started on Monday morning, has increased in size since then. Today is Thursday 4/15. It is red, a bit swollen. It is very itchy and hot to the touch. Left hand also feel tingly on and off. It is also a bit painful, feels sore like when I first received the shot.

Other Meds: None

Current Illness: Seasonal Allergies

ID: 1214034
Sex: M
Age: 24
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe Head Ache

Other Meds:

Current Illness:

ID: 1214035
Sex: F
Age: 17
State: NC

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 3 episodes of vasovagal syncope this morning, clustered over approximately 1 hour, on the day following her second dose of Pfizer Covid-19 vaccine.

Other Meds: none

Current Illness: none

ID: 1214036
Sex: M
Age: 24
State: AL

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Nose bleeds while sleeping and during the next day

Other Meds:

Current Illness:

ID: 1214037
Sex: F
Age: 71
State: MI

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: CODEINE

Symptom List: Nausea

Symptoms: AFTER RECEIVING THE VACCINE SHE FELT HER LIPS TINGLING. ON SITE EMS RESPONDED. VITALS BELOW. 50MG DIPHENHYDRAMINE WAS GIVEN ORALLY. SHE WAS RELEASED TO HOME. IT WAS SUGGESTED SHE CONFIRMED WITH HER PRIMARY IF SHE SHOULD GET THE 2ND DOSE.

Other Meds: LABETOLOL/NORVASC/COZAAR/ALLOPURINOL/CHLORTHALIDONE

Current Illness:

ID: 1214038
Sex: F
Age: 69
State: AZ

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Possible allergy to Statins

Symptom List: Injection site pain

Symptoms: Minor headache late evening on vaccination day the 24th around 2:00 pm. Next morning minor headache generally not feeling well, around noon headache became intense and pressure in my chest, so not comfortable lying down, sat up and walked around much of the night. Finally took ibuprofen which didn't help. Next day I was a bit tired but done with the headache and feeling of illness. Worst lasted about 12-15 hours.

Other Meds: Vitamin B12, Magnesium, CoQ10, Omega/D3, probiotics in the morning.

Current Illness: None

ID: 1214039
Sex: F
Age: 53
State: MI

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Pt reported not feeling well and felt like she was going to vomit. Pt ran to the bathroom and proceeded to have an episode of diarrhea and an episode of vomiting. The pt stated, "I ate some breakfast this morning that may have been sitting out for too long".

Other Meds: n/a

Current Illness: n/a

ID: 1214040
Sex: F
Age: 15
State: AL

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: VACCINE WAS GIVEN ON 3/24/21 AND 4/14/21 TO INDIVIDUAL UNDER AGE OF 16 . FOLLOW UP WAS PERFORMED WITH INDIVIDUALS MOTHER AND SHE VOICED SHE WANTED HER CHILD TO HAVE IT BECAUSE SHE (MOTHER) WORKS IN HEALTHCARE. NO ADVERSE REACTIONS OR EVENTS WERE COMMUNICATED. VERBALIZED TO CALL IF ANY REACTIONS OCCUR AND TO PLEASE REPORT TO HER PHYSICIAN THAT HER CHILD WAS VACCINATED UNDER THE AGE OF 16.

Other Meds: none

Current Illness: none

ID: 1214041
Sex: M
Age: 63
State: CA

Vax Date: 04/12/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: Woke up on 4/15/21 w/ "stinging to lips", generalized facial swelling present. No rash, SOB, or hives present.

Other Meds: Aspirin 81mg QD, Atorvastatin 40mg QD, hydrochlorothiazide 25mg QD, Metoprolol succinate ER 100mg BID.

Current Illness: N/A

ID: 1214042
Sex: M
Age: 54
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Fatigue and body ache started approximately 6.5 hrs after shot. Low fever (1.5 degrees f above normal) started 10 hours after shot at which point I took 1 200mg ibuprofen capsule. High fever (5 degrees f above normal) and chills were experienced at 12 hours after shot at which point I took 2 200mg ibuprofen capsules. By 22 hours after shot fever was back to a low level. Fever was gone approximately 30 hours after shot and fatigue and body ache continued until approximately 48 hours after shot.

Other Meds:

Current Illness:

ID: 1214043
Sex: M
Age: 57
State: OH

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: Seasonal, Grass, Ragweed, Dust Mites, Mold, Poison Ivy

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Itching, rash, blisters on arms and hands starting 48 hours after injection. Worse on elbow near injection site. Using antihistamine (Zyrtec) and OTC steroid cream.

Other Meds: Glipizide, Simvastatin, Singular, HCTZ, Vitamin D

Current Illness: none

ID: 1214044
Sex: F
Age: 94
State: NC

Vax Date: 03/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Received Pfizer vaccine 4/13/21

Other Meds: Hydrochlorothiazide, SPS suspension, Remeron, Calcium+D, Tylenol

Current Illness: None

ID: 1214045
Sex: F
Age: 71
State: MI

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: CODEINE, CAUSES ITCHY AND HIVES

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: TODAY SHE RECEIVED HER 2ND DOSE (IT WAS APPROVED BY HER MD). 5 MINUTES AFTER RECEIVING IT, HER LIPS STARTED TO TINGLE AND RECEIVED 25MG OF DIPHENHYDRAMINE ORALLY. ON SITE EMS RESPONDED. SHE SAID SHE HAD THE SAME REACTION WITH THE FIRST COVID VACCINE 3 WEEKS PRIOR. WITH THE FIRST DOSE SHE WAS GIVEN 50MG DIPHENHYDRAMINE AND WENT HOME, TOOK A NAP AND WAS FINE. SHE FELT BETTER AND WAS RELEASED TO HOME

Other Meds: LABETOLOL, NORVASC, COZAAR, ALLOPURINAL, CHLORTHALIDONE

Current Illness: BRONCHITIS

ID: 1214046
Sex: F
Age: 48
State: CA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Solomedrol, erythromycin, gluten, jasmine

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Tired, weak after vaccine. Took 10mg cyclobenzaprine at 930pm. Started to get uncontrontollable chills and shivers after 10pm. At 12:30 am woke up to use restroom and i could barely walk...my entire body was rigid from head to toe, almost fell down. Couldn't bend legs, ankles, hips, etc. Slept until 830am 4/15. Still stiff, but not as bad as earlier.

Other Meds: Ocrevus, Cyclobenazprine, aller-tek, B12, Vitamin D, magnesium, fish oil, acetaminophen.

Current Illness: None

ID: 1214047
Sex: F
Age: 19
State: OK

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: 117/70 PULSE 97 C/O SHARP CHEST PAIN UPPER RIGHT CHEST AND DOWN RIGHT ARM AT 15MIN MARK. LAID DOWN ON COT AND 911 CALLED. ADMITTED TO HAVING ANXIETY ABOUT THE SHOT. ABLE TO MOVE FINGER ON RIGHT ARM BUT STATES SHE CANNOT FEEL HER FINGERS. DENIES SOB. BP AFTER 5 MINUTES BP 116/71 PULSE 94. RIGHT ARM AND HAND WARM TO TOUCH AND STATED SHE FELT ME TOUCH HER. RADIAL PULSE RIGHT WRIST GOOD. C/O DIZZINESS. PATIENT IS DEVELOPMENTALLY DISABLED. CAREGIVER STATES PATIENT AGREES TO ALL QUESTIONS. C/O STOMACH PAIN, DENIES NAUSEA. B/P AFTER 10 MINUTES 115/72 P 92 DENIES SOB. RATES CHEST PAIN ON A 0-10 AT A 10. STATES STILL CANNNOT FEEL FINGERS. PARAMEDICS ARRIVED AND HOOKED PATIENT UP TO A 12 LEAD YIELDING NORMAL RESULTS. PATIENT DID NOT GO TO THE HOSPITAL WITH PARAMEDICS.

Other Meds: FLUOXETINE 10MG VIT C W/ B COMPLEX DIVALPROEX 250MG & 500MG MELATONIN 3MG OLANZAPINE 10MG DESMOPRESSIN 0.2MG VIT D3 5000IU LORATADINE 10MG FLUTICASONE

Current Illness:

ID: 1214048
Sex: M
Age: 68
State: KS

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 04/15/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: not reported

Symptom List: Pain in extremity

Symptoms: Vaccination 2-12-21 chest pains 2-12-21 evening heart attack 2-13-21 Flown from first hospital to second hospital 2-13-21 night stent applied, breakout in rash and hives on 2-17 severe.

Other Meds: not reported

Current Illness: not reported

ID: 1214049
Sex: F
Age: 61
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Pt with severe headaches for 2 days after vaccination. Also vision changes, bilateral temple pain/tenderness. Improved after from 10/10 to 3/10, but headache continues through today 4/15/21. Workup is ongoing.

Other Meds: aspirin, multivitamin, Zofran

Current Illness:

ID: 1214050
Sex: M
Age: 50
State: CT

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 04/15/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: contrast dye

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: developed chest pain and shortness of breath 12 hours after vaccination and went to ED and hospitalized with PE and DVT and now on xarelto

Other Meds: isoniazid, vitamin B6, rifabutin

Current Illness: mycobacterium tuberculosis of left ankle

ID: 1214051
Sex: F
Age: 35
State: TX

Vax Date: 03/26/2021
Onset Date: 04/01/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Severe rash all over body that itched and burned

Other Meds: None

Current Illness: None

ID: 1214052
Sex: F
Age: 65
State: NY

Vax Date: 03/31/2021
Onset Date: 04/03/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Bactrim, Trimethoprim, Erythromycin, Codiene, Minocycline, PCN, Environmental

Symptom List: Vomiting

Symptoms: Nausea, joint pain, rash , itch in throat, tongue swelling .

Other Meds: Zyrtec, HCTZ, Methylphenidate, Venlafaxine, Fluoxetine, Fluticasone-salmeterol inhaler

Current Illness: none

ID: 1214053
Sex: F
Age: 23
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fevers and chills from 1700-0500 April 1st

Other Meds:

Current Illness:

ID: 1214054
Sex: M
Age: 60
State: FL

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/15/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: CODIENE- SEVERE NAUSEA/VOMITING

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: 3/31/2021: 6-7 HOURS S/P VACCINATION: HEADACHE, FEVER, COLD CHILLS, SWEATING, AND DRY HEAVES 3/31/2021-4/1/2021: UP AND DOWN ALL NIGHT, DIARRHEA, BODY ACHES, STOMACH ACHE, HEADACHE, DRY HEAVES 4/1/2021-4/4/2021: ABOVE SYMPTOMS CONTINUED . 4/4/2021: STARTED HAVING CHEST PAIN AND WENT TO MEDICAL CENTER - ER . WAS ADMITTED TO HOSPITAL FOR TREATMENT OF A-FIB. 4/8/2021: DEVELOPED A RASH ON BACK.

Other Meds: LISINOPRIL 5 MG DAILY, METOPROLOL TARTATE 50MG TWICE A DAY, CRESTOR 20 MG DAILY, ASA 81 MG DAILY

Current Illness: NONE

Date Died:

ID: 1214056
Sex: M
Age: 71
State: MI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: denied any allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: got up out of his chair to leave from his 15 minute wait and fell face down on the floor. He did not put his hands out and received a cut on his left cheek below eye from glasses. He was assisted onto his feet and back onto his chair. Vital signs were BP-117/64, Pulse 85, RR 18, O2 sat 98% (WNL). Water provided to patient. Had him take several deep breaths. Band Aid applied to cut on cheek. Patient did not complain of any symptoms. Denies dizziness. Refused to seek further medical attention or go to ER. He was then assisted back to his car by staff after the incident.

Other Meds: denied blood thinners during screening/unknown if taking other meds

Current Illness: unknown

ID: 1214057
Sex: M
Age: 17
State: TX

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient describes no adverse events

Other Meds:

Current Illness:

ID: 1214058
Sex: F
Age: 64
State: CA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Patient c/o of light headedness, VS stable. Water offered, patient refused to lay down on a gurney. Discharged home at 3:40 pm when symptoms resolved.

Other Meds: unknown

Current Illness: HYPERLIPIDEMIA ASTHMA, UNSPECIFIED FHX OF OVARIAN CANCER VITAMIN D DEFICIENCY BILAT TMJ DISORDER LEFT BUNION BRONCHOSPASM ROSACEA

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm